Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis
Autor: | Erik Lubberts, Marijn Vis, Priyanka S Bangoer, Johanna M. W. Hazes, Marc R. Kok, Ilja Tchetverikov, Adriana M. C. Mus, Nadine Davelaar, Jolanda J. Luime, K. Wervers, Hannah den Braanker |
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Přispěvatelé: | Rheumatology |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
musculoskeletal diseases Adult Male medicine.medical_specialty Epidemiology Immunology Psoriatic Arthritis lcsh:Medicine Disease Interleukin-23 Severity of Illness Index 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Rheumatology Internal medicine medicine Immunology and Allergy Humans skin and connective tissue diseases Aged 030203 arthritis & rheumatology Oligoarthritis business.industry lcsh:R Arthritis Psoriatic Interleukin Middle Aged medicine.disease Prognosis 030104 developmental biology Methotrexate Treatment Outcome Antirheumatic Agents Cytokines Polyarthritis Female Inflammation Mediators business Biomarkers medicine.drug Cohort study |
Zdroj: | RMD Open, 6(2):e001175. BMJ Publishing Group RMD Open RMD Open, Vol 6, Iss 2 (2020) |
ISSN: | 2056-5933 |
Popis: | ObjectivesMethotrexate (MTX) is currently the recommended first-line therapy for treating psoriatic arthritis (PsA), despite lacking clear evidence. No estimates of efficacy of MTX in usual care and no clear MTX responsive clinical or laboratory variables are currently available. This study describes the response to MTX monotherapy in newly diagnosed patients with PsA in usual care. Second, we compared clinical variables and cytokine profiles in patients responding and not responding to MTX monotherapy.MethodsWe used data collected in the Dutch southwest Early Psoriatic Arthritis cohoRt study to select patients with PsA with oligoarthritis or polyarthritis, and at least 1 year follow-up. We analysed disease activity at 6 months of patients who started MTX monotherapy and still used MTX monotherapy 1 year after diagnosis. Cytokine profiles were determined at baseline and after 3 and 6 months with a bead-based multi-immunoassay.ResultsWe identified 219 patients of which 183 (84%) patients started MTX monotherapy within 6 months after diagnosis. 90 patients used MTX monotherapy throughout the first year of which 44 patients (24%) reached minimal disease activity(MDA) at 6 months, decreasing to 33 patients (18%) after 1 year. Non-responders had significantly higher concentrations of interleukin (IL) 23 and IL-10 before and during MTX therapy.ConclusionsOur results showed that only 18% of patients with PsA are in sustained MDA after 1 year of MTX monotherapy and non-responders more often had IL-23-driven disease. Our results indicate the need for more treat-to-target and personalised therapy strategies in PsA. |
Databáze: | OpenAIRE |
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